Della Valle Alejandro González, Rana Adam, Furman Bridgette, Sculco Thomas P, Salvati Eduardo A
Hospital for Special Surgery, New York, NY 10021, USA.
Clin Orthop Relat Res. 2005 Nov;440:184-91. doi: 10.1097/01.blo.0000177719.16146.33.
Modern modular components with maximized conformity between liner and shell, improved locking mechanisms, and smooth inner surfaces should have less backside wear than first-generation modular designs. Also, nonmodular components should show no backside wear in vivo. We compared the backside wear of retrieved liners from nonmodular and modular components from first-generation and second-generation designs. We matched for time in situ, patient age and weight for nine retrieved Harris-Galante Type 1 liners, nine Harris-Galante Type 2 liners, nine Trilogy liners, and nine Implex nonmodular liners. The backside of the liners was divided in quadrants, examined under a x10 binocular loupe, and rated by a score of 0 (absence of wear) to 3 (severe backside wear) for a total ranging from 0 to 12. The average total backside wear score was 8.4 for the Harris-Galante Type 1 liner, 7.3 for the Harris-Galante Type 2 liner, 3.7 for the Trilogy liner, and 2.3 for the Implex liner. We observed a significant reduction in the backside wear of modern modular and nonmodular acetabular components (Trilogy(R) and Implex) when compared with first-generation modular designs (Harris-Galante Types 1 and 2). Nonmodular acetabular cups had a low backside wear in vivo.
Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.
具有衬垫与髋臼杯之间最大程度贴合、改进的锁定机制以及光滑内表面的现代模块化部件，与第一代模块化设计相比，后侧磨损应更少。此外，非模块化部件在体内应无后侧磨损。我们比较了第一代和第二代设计的非模块化和模块化部件中取出的衬垫的后侧磨损情况。我们对9个取出的Harris-Galante 1型衬垫、9个Harris-Galante 2型衬垫、9个Trilogy衬垫和9个Implex非模块化衬垫的在位时间、患者年龄和体重进行了匹配。将衬垫的后侧划分为象限，在10倍双目放大镜下检查，并根据0（无磨损）至3（严重后侧磨损）的评分进行评级，总分范围为0至12。Harris-Galante 1型衬垫的平均后侧总磨损评分为8.4，Harris-Galante 2型衬垫为7.3，Trilogy衬垫为3.7，Implex衬垫为2.3。与第一代模块化设计（Harris-Galante 1型和2型）相比，我们观察到现代模块化和非模块化髋臼部件（Trilogy和Implex）的后侧磨损显著减少。非模块化髋臼杯在体内后侧磨损较低。
治疗性研究，III级（回顾性比较研究）。有关证据水平的完整描述，请参阅作者指南。
